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See a sample rate comparisonCPT 96369 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Subcutaneous Infusion For Ther, Subcutaneous Infusion For Therapy Or Prophylaxis (Specify Substance Or Drug) Initial Up To 1 Hourincluding Pump Set-Up And Establishment Of Subcut Aneous Infusion Site(S)
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Hydration, Therapeutic, Prophylactic, Diagnostic Injections and Infusions, and Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration |
| Common Place of Service | 11 - Office 20 - Urgent Care Facility |
| Common Modifiers | None 59 - Distinct Procedural Service XS - Separate Structure |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 96369 |
| Medicaid Fee Schedule | View Medicaid rates for 96369 |
National average reimbursement for CPT 96369 by major payers:
$205.71
$208.92
$189.28
$256.12
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CPT 96369
5 of 25 sample ratesHigher to lower in this preview
Mark Wainwright
Pediatric Faculty Foundation In
$419.10Published rateLauren Hassoun
Scott & White Clinic
$259.77Published rateRobert Brown
Houston Male Health Clinic PLLC
$217.35Published rateMarichel Marcolino
$141.65Published rateLewis Family Medicine
Lewis Family Medicine PLLC
$129.63Published rate
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See a sample payer proposalCPT 96369 vs. Other Hydration, Therapeutic, Prophylactic, Diagnostic Injections and Infusions, and Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration Codes
The CPT 96369 code is part of the Medicine Services and Procedures services used for Hydration, Therapeutic, Prophylactic, Diagnostic Injections and Infusions, and Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 96369 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 96360-CPT | Low | Fluids Given By Iv To Hydrate, Saline Or Other Fluids Given By Iv. The Fluids Rehydrate The Body After The Normal Fluid Level Has Dropped From Vomiting Diarrhea A High Fever Or Other Symptom. |
| 96361-CPT | Low | Fluids Given By Iv To Hydrate, Saline Or Other Fluids Given By Iv. The Fluids Rehydrate The Body After The Normal Fluid Level Has Dropped From Vomiting Diarrhea A High Fever Or Other Symptom. |
| 96365-CPT | Low | Iv Infusion, An Iv Infusion Delivers A Fluid Or Medication Over One Hour. Infusion May Be Part Of A Therapy Preventive Measure Or A Part Of A Test. |
| 96369-CPT | Moderate | Subcutaneous Infusion For Ther, Subcutaneous Infusion For Therapy Or Prophylaxis (Specify Substance Or Drug) Initial Up To 1 Hourincluding Pump Set-Up And Establishment Of Subcut Aneous Infusion Site(S) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 96369. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 96369 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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